EP16 - WW

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John Salak: I don't want to sound like some old grumpy guy, even if members of my family think I am. [00:00:36] But in my younger days, think Gilligan's Island and the 69 Mets, food allergies were kind of unheard of. Okay, maybe somebody's distant cousin or relative didn't like peanuts or shellfish, for whatever reason, but you just didn't hear a lot about allergies.

Now it seems like almost everyone is dealing with a food allergy of some sort, and this doesn't count food intolerances, which are a different problem altogether. So what gives? Are we just more aware of allergies, and is there less of a stigma attached to having them? Or are we more susceptible to them?

Well, we are [00:01:12] certainly more aware, and this makes dealing with them in public much less of an issue than, say, 10, years ago. But the other cold fact is that more people than ever, from infants to adults, have allergies today. Oh, and in case anyone is wondering, a food allergy occurs when the body has a specific and reproducible immune response to certain foods.

The response can be more than just annoying, it can be deadly in extreme cases. Currently, this growing problem affects about 20 million adults in the U. S., about 6 percent of the population. It also affects between 4 and 6 million [00:01:48] children, which represents about 6 to 8 percent of that group. Why the increase?

It's likely a combination of factors, including the growing consumption of processed foods, the drive to live clean. Which means our immune systems now overreact to certain foods. Possibly a decrease in vitamin D intake, and even the evolving nature of our gene pools. The bad news is there's no current cure to food allergies.

The good news is that the growing public awareness of the problem... means it's easier to protect yourself from the related dangers at home, school, work, and play. Our upcoming [00:02:24] guest is going to help lay out exactly what these dangers are, who is at high risk, and how those in the food allergy crosshairs can better protect themselves.

Welcome to this section of What the Health Podcast.

This is where we're going to bring in one of our celebrity guests and authority in this case, Dr. Vincent Ho who is associated with Western Sydney, Australia, and the associated medical facility there. Dr. Ho has become an authority and expert on food allergies, especially in younger children, but, certainly understands the impact both on younger children, [00:03:00] adults, and adolescents.

So we're going to talk to Dr. Ho about this. So one, Dr. Ho, welcome to the broadcast. Thank you for taking the time to speak with us. And also, I forgot to mention Dr. Ho just produced a new book on food allergies for young people, and we're going to have him describe that book in a second. So Dr. Ho, welcome .

Vincent Ho: Thank you so much for inviting me, and I'm delighted to be here. I find this entire topic of food allergies a very fascinating one and it's a very personal one because it relates to my daughter, Olivia. Olivia is now eight years old, [00:03:36] but when she was six months she had a quite a significant reaction to a egg.

So my extended family were out at a restaurant and she tried a bit of an egg tar and we noticed that she developed a rash which spread across her face. She started getting a bit wheezy.

And then I got quite concerned and, my background is as a gastroenterologist. So I've done my medical training in gastroenterology, but at the time when I saw my daughter getting this reaction, despite all my medical training, I actually felt quite powerless. I didn't have any [00:04:12] resources at the time in the restaurant.

There wasn't any EpiPen that was available. So, for a few, I guess, terrifying moments as a parent. This was very concerning and a very worrying time for me. And really when I look back upon it, it was one of the most sort of harrowing events, the thought that you could lose your child at that time.

Fortunately, and we rushed to take her to the nearby hospital and as we were transporting her direction started to subside. Which was really fortunate and by the time we got to the emergency department, she was assessed as actually quite stable and the [00:04:48] recommendation was that she would follow up with an allergy specialist.

So, once this happened I was very motivated to really research into allergies and, what I began to realize was that there was a linkage between the gut itself and allergies and I developed a keen interest in the area and I wrote a book which you mentioned the healthy baby gut guide.

Which is a guide which examines the role of allergy and the connection between the gut. It talks about ways in which infants and children [00:05:24] can develop their immune systems and strategies to help reduce the risk of allergies. So that's where the book comes from. It comes from a deeply personal experience.

And I'm very pleased to be able to talk to you today about what I found personally from my own research about allergies.

John Salak: And that's fascinating and also troubling for your medical background I imagine a lot of parents are going to be at an even greater disadvantage, one because you're a medical doctor, and you have a background in [00:06:00] this area, so you began to see the impact of your daughter's potential food allergy, perhaps, and the seriousness of it, perhaps more readily than Some other parent would.

And that's kind of frightening to parents out there, I would assume.

Vincent Ho: You're absolutely right. And even though I have a medical background, I'm by no means immune to this stress that's involved when you have a loved one in front of you that's going through a very serious reaction.

I mean, it's a very concerning. And I can actually [00:06:36] see why parents would be very concerned about even trialing certain foods. on their infants for the first time. So, for example, it's not unheard of, for parents try their infants on peanuts in their car, just outside a hospital, just in case.

There's a reaction and they can rush their kids over to the emergency that can happen. So there's a lot of anxiety out there and I guess what I wanted to do today is to hopefully provide at least some useful information and perhaps some reassurance about allergies.[00:07:12]

John Salak: And that's exactly why we're glad you're here.

And forgive me if someone didn't realize this when I said Western Sydney University, Dr. Ho is a native of Australia and is speaking to us from Australia. And some of the statistics, I wanted to get a handle on how extensive the problem is, how serious it is for younger children.

And then we're going to talk about adolescents and adults in a minute. But the statistics I have on food allergies are from the states, so it's not that we want to be state centric, but I just want to gauge if that's similar to what we might see around the other countries,

in the [00:07:48] states, it looks like there are 20 million people, adults and younger children, who suffer from food allergies. These are the latest statistics we have, and it's about 6 percent of adults. and roughly about 6 percent of young Children. Is that what we would see worldwide? Is that what we would see in a country like Australia in terms of percentages?

Vincent Ho: Yeah. So, when it comes to Western countries, we know that the food allergy rates are generally similar around the world. We know, for example, in Australia, New Zealand that when it comes to food allergies, it's thought that about 10 percent of infants [00:08:24] will have a food allergy, and maybe anywhere from 4 to 8 percent of children will have a food allergy, and with adults, probably one in every 50 people will have a food allergy. So that's probably about on par with the figures in the United States. What is interesting though in both United States and in countries such as Australia and New Zealand is that the numbers of people with food allergy is on the rise. And we know that approximately there's a doubling in each of the last few decades.

So we know that the rate of food allergies seems to be on the [00:09:00] rise. So, there is certainly something in the environment that seems to be linked to the rise in allergies, but it is a an extremely common problem food allergies as a key part of that

John Salak: You talked about the percentages and that's significant no matter where you are, whether it's 1 percent or 10%, it's obviously significant.

How serious are food allergies? And it's certainly troubling to anyone who's going to see an infant, a young child suffering from food allergies or having a response to that, but we're trying to get a handle on how threatening can they [00:09:36] be, especially because these young children can't communicate in the way adults or older children would communicate.

Vincent Ho: So allergies can be potentially very serious. So I talked about my daughter. Olivia having a reaction. Unfortunately, she didn't have a condition called anaphylaxis, but anaphylaxis itself is probably the most serious response to a particular food that someone can experience.

So anaphylaxis occurs when there's exposure to an allergen. And in the case of food that could be something, for example, like, peanuts or wheat or [00:10:12] could be milk. There's quite a number of common foods, which are very common food allergens. But what happens with anaphylaxis is that it's a very serious, life threatening reaction.

So typically, the symptoms might include for young children, difficulty or very noisy breathing, swelling of the tongue, swelling or tightness in the throat. Making it a wheeze or a persistent cough and it can lead to rapidly lowering blood pressure, shock, and even death. So anaphylaxis is very serious.

We know that for certain types of food allergies, for example, [00:10:48] peanut allergy, which is a very common type of food allergy, about one in 50 children will have peanut allergy and about one in 200 adults. It is peanuts, for example, is a very common food that can cause anaphylaxis and death.

And we know that about one in every 200 episodes of anaphylaxis. will lead to death. So this is actually a very serious problem. there's probably about 150 children that die from a food allergy, anaphylaxis in the United States every year. About a hundred of those cases are due to peanut [00:11:24] allergies.

a real problem and my personal belief is what the one child that, passes away is one child too many.

John Salak: Absolutely. And we had, again, looking at some initial research and you certainly should correct me if I'm wrong, that milk, eggs, peanuts, tree nuts, soy, wheat are the most common foods in terms of creating a food allergy or igniting a food allergy, but you're mentioning peanuts as one of the.

foods most likely to create an anaphylactic reaction. Are there other foods that are in that same danger zone?

Vincent Ho: Yeah. So, so certainly [00:12:00] we know that peanuts and tree nuts we know that shellfish they can lead to quite serious reactions. I mean, the other, as you mentioned, milk, egg, wheat and soy they can, of course, cause a reaction but typically we know that.

When it comes to particular foods like milk, egg, wheat, and soy those sorts of allergies tend to resolve in childhood in the majority of cases. So the good news is that for some of those foods, you can outgrow it.

However other types of allergies, which we just talked about peanuts, tree nuts, seafood, [00:12:36] those reactions generally persist throughout someone's lifetime.

John Salak: That's fascinating and frightening at the same time. Given the demographic of young children, let's say before adolescence, is there a group within that infant to say 12 year old range that are most at risk from serious food allergy reactions?

Or is it a matter of infants or, toddlers maybe more at risk mainly simply because they don't communicate or they're more likely to grab a food that they shouldn't?

Vincent Ho: Yeah, so that's a really interesting question. And what we know from the data [00:13:12] is that adolescents are the age group that have the highest frequency of fatal reactions.

So it's the adolescent group that is the most at risk. And we think there's a number of reasons for why that might be. Certainly we know that for infants, what happens after. Birth is that there is this sort of reactivity that is there, but this reactivity quickly dampens down.

So, most infants, this reactivity will actually dampen down pretty quickly, and . We know that there will be a subgroup [00:13:48] of young children. Where that reactivity, and it's a pretty good kind of immune reactivity that will persist. And so those children that have that reactivity, that can persist.

And that's the group that we have to watch and we have to be very mindful about. But what we also realize is that these children are often, their allergies are usually managed very well by their parents. And as they get a bit older certainly, we know that up to the age of say eight children are relying very heavily on their parents to manage the food [00:14:24] allergies.

But after that age, as they progress into adolescence, they become a bit more aware of the difficulties of managing it and often they are instructed to manage their allergies themselves. And as they get a bit older, maybe there's some beliefs that begin to misalign, when you get to that point as an adolescent, parents know best.

Can sometimes lead to some more riskier behaviors as the adolescents try to assert their independence. And, so that there is a kind of a danger zone there around adolescence where there's a reason why. There's that high, higher frequency of fatal reactions.[00:15:00]

John Salak: That's fascinating. I imagine peer pressure comes into it, the whole idea you're almost indestructible as an adolescent. That's fascinating and kind of frightening. Let's go back a little bit, to the rise in food allergies, because it's something that's, fascinating because I do not remember as many friends having food allergies. I don't remember them being lactose intolerant. I don't remember as many people being gluten intolerant. And for me, I wonder, is it a matter of awareness that we weren't aware that people had these problems, we weren't attuned to them, we [00:15:36] figured you'd just suffer through them.

Or is it a matter that it's rising because of something in the environment, something that's happening with our gut health or whatever it may be. So any enlightenment you can share on that would be most welcome

Vincent Ho: This is a very interesting area and it's an area that I outlined in my book in some detail.

But there is certainly an increased prevalence of allergic diseases. They're not just food allergies, but other allergies as well. And this rise has been steady. We know from all the data it's been steady. Around the [00:16:12] beginning of modern industrialization, and it tells us there's something in the environment that seems to be Helping to shape the susceptibility of people to allergy and I wanted to bring the concept of the hygiene hypothesis, this is a term that, has become very popular, but it's a term that, that I think sometimes is kind of misunderstood and this term hygiene hypothesis, Contrary to popular belief, it doesn't mean that you actually should disregard personal hygiene and become a slob and hope that somehow that makes you less likely to get allergies.

if you don't mind, talk briefly about the hygiene [00:16:48] hypothesis and why it's really

John Salak: important. Absolutely. And I think we've touched on this in other areas of our writing, both on WellWillUSA and in our podcast, but please go ahead.

Vincent Ho: Yeah. So this is a really fascinating story in how the hygiene hypothesis has come about.

So we know that in 1989 a London epidemiologist, Professor David Straughan, He published in the British Medical Journal the results of a survey of more than 17, 000 British children in order to help understand what could be behind the increase in the instance of hay fever in [00:17:24] post war Britain.

And he found a very curious pattern in the data. He found that the more older siblings a child had, They're less likely that he or she was to develop eczema by the age of one year and hay fever by the age of 23. So, he recognized there was some protective effect that the older siblings was passing on to the younger children.

And, as a parent, I know that, when they're playing, kids can be a bit feral, they can bite and scratch and along the way, something is being [00:18:00] conferred from the older sibling to a younger one that seems to be protective against allergy, and so Professor Straughan felt this specific protective effect was exposure to microbes.

Early child exposure to microbes to protect against the development of allergies by affecting the development of the immune system. And that's what the hygiene hypothesis is about. It's about exposure to these particular microbes protecting against the development of allergies by maturing or affecting the development of the immune system.

And so that [00:18:36] concept of the hygiene hypothesis was then latched upon by the scientific community. And we now realize that and it's diving into it in a little bit more detail, that there are actually some inflammatory molecules that are involved in this process. And these inflammatory, what we call cytokines, are important in terms of getting rid of bacteria that get inside our cells.

So we know that if you've got a very vigorous inflammatory response that can cause some tissue [00:19:12] damage. And so as a way to counteract that, there are other cytokines which are protective against that. So those protective responses, which are anti inflammatory are very good and and they can help.

Fight off parasites, for example, but the problem is that if you've got a very vigorous anti inflammatory response, it can actually help promote allergy. And so that's what we're discovering that if you've got a very powerful anti inflammatory response allergy, and what we're finding is that when we look at the immune system, [00:19:48] is that what we call, that promoting allergy response that is favored by the widespread use of antibiotics, a more industrialized lifestyle. Those are the sorts of things that can help favor the promotion of allergy, whilst things that help to protect against allergy, which is sort of the inflammatory response, presence of older siblings.

Early exposure to daycare, household pets, childhood infections, and exposure to a rural farming environment. So those are protective effects against allergy.

John Salak: We have written about [00:20:24] similar pattern you mentioned children who are exposed to pets have a lower risk factor for allergies and other elements.

And I know that's a simplistic approach, but it seems to fall in line with what you're saying. So that's fascinating. What about our foods themselves? Is food processing or the foods we eat or how the food's prepared is that also creating any impact on food allergies?

Vincent Ho: Yeah. So short answer to that is. Yes, although the evidence isn't all that clear. We do know that there are certain aspects of industrialization or which are involved in the processing of [00:21:00] food. So, for example, we know that exposure to herbicides.

Which is used in agriculture that has been linked to the rise in allergies and certainly so that's something and it's been shown with the data sets that can be associated with allergies. We know that pollution itself has been linked to allergies.

So there are factors in our environment, which are associated with allergies. Sometimes it's difficult to identify exactly what that is especially when it comes to the modern food manufacturing processes. It's difficult to know. I mean as I mentioned, very broadly the use of certain types of [00:21:36] chemicals herbicides, but because there's a lot of chemicals that are used in the environment it's difficult to isolate exactly which particular chemical if you will, is linked to allergies.

So it's part of the difficulties in the research to be able to work out which one, but in general, we can make some observations that exposure to herbicides, exposure to certain types of pesticides can be linked to a rise in allergies.

John Salak: That's fascinating. It sounds like the issue with food allergies sort of is established at a very young age or maybe with birth.

Can you [00:22:12] develop food allergies as you mature?

Vincent Ho: This is actually a very important point that you've raised, and I think that there was this myth, if you will, that food allergies was something that was pretty exclusive to, infants and young children, but what we know is that actually, adults are also allergic susceptible to development of allergies, and this is actually a very and really important point.

So adults with no history of food allergies can unexpectedly develop them, and we [00:22:48] know that from some research, so there was a survey of more than 40, 000 adults, which was published in the Journal of the American Medical Association, and this research found that nearly half of adults who reported being allergic to a certain food or ingredient developed the allergy in adulthood.

And we know that nearly 11 percent of adults reported having a food allergy and adult onset food allergies represents about half of those cases. So it's amazing. Yeah, adult food allergies are more common than previously believed. [00:23:24] And they tend to be more severe compared to allergies developed during childhood.

John Salak: Do we know why this is occurring and what type of allergies we're talking about in general? And I, this sounds like it's more the research into this a little more cutting edge. So maybe these answers aren't as apparent.

Vincent Ho: Yeah. we're not entirely clear why this is occurring.

We think that, again, this relates to factors in the environment. So, certainly in the western world, we know that we are living in generally in a more cleaner environment. And as a consequence of that, there's certainly going to be less exposure to a lot of those [00:24:00] microbes that were present in the past.

So these microbes were known as what we call them the old friend microbes. And so these old friend microbes have been around with us for a long time, but because of what's been happening with modern industrialization, we don't have access those modern microbes anymore. So there is a hypothesis going around that with adults, given that adults are paying a lot more attention, if you will, to personal hygiene.

So compared to young children, adults tend to be more vigorous about cleanliness. And that's a good thing. [00:24:36] But at the same time, it means that there's less exposure to some of those old friend microbes, which are thought to be protective against allergy. And so that's one hypothesis that perhaps in the world less exposure to those microbes as we become older and we become more conscious about personal hygiene and we consequently adopt more personal cleaning practices that may be.

The reason for why this is kind of, rise in adult onset food allergies and with that as well, I mentioned before that [00:25:12] the allergies tend to be more severe, but allergies during childhood, I think, in general, that's probably true when we recognize that, when children are very young , their immune systems are maturing, particularly in the first few years of life.

And so the reaction typically is going to be less than a more mature immune system. And that, the thinking behind the severity of an allergic reaction.

John Salak: Do these reactions for old or mature adults tending to gear towards peanuts and and certain things or is it just pretty much all across the [00:25:48] board?

Vincent Ho: Yeah, it appears to be across the board.

John Salak: Is it true there's about 170, 175 foods that tend to cause allergies?

Vincent Ho: Well, if you look at very specific, ingredients. I think you're in the ballpark there when it comes to the different types of foods.

I would say, though, that the vast majority, and I would say that, 90 percent of food allergies would be limited to about eight or nine different types of foods. So, with that we can go through them. So egg allergy, for example, is, a very common one.

I talked about peanuts of [00:26:24] course, before. We've got allergy, we've got seafoods, we've got tree nuts, so treat slightly different from peanuts. And you've got weed allergy as well. And so those are the really common ones. And I should also mention milk allergy too.

They are the really common foods that account for more than 90 percent of food allergies out there. And actually what you'll find is, because they are so common, we know that...

food manufacturers have to indicate on food labels the presence of those particular foods. [00:27:00] Obviously when it comes to food labels, they don't have to label every single particular ingredient. And when it comes to really rare types of foods, maybe linked to allergies, that's not labeled, but that certainly those big eight foods are labeled.

John Salak: Now, with adults, we're seeing a rise in allergies that, for these adults, later in life. Is it more dangerous for adults than they may assume because this is coming out of the blue to them, or are they saying, ah, this must be an allergy, I have to take care of it.

Vincent Ho: Yeah. So again, it seems to be something that is somewhat generational in the sense [00:27:36] that, I think you mentioned early on in your introduction that when we were growing up, there just wasn't, necessary awareness of these food allergies and, there probably just wasn't the prevalence of food allergies for children just wasn't what it is today.

It is now. So I think that when it comes to individuals, and think sometimes when it comes to older individuals, it's possible that if they're not, aware of the importance of these food allergies, especially if they've ever had any personal experience with food allergies growing up.

Then there may not be awareness of the [00:28:12] importance of food when it comes to children and especially about certain instructions about what to do when managing children. And this could actually be very relevant, when it comes to say, grandparents have looking after, young children, because, think that there needs to be a lot of sensible precautions.

If there's confirmed food allergies, we have to be extremely vigilant. And what I mean by that is that we have to be very careful about reducing exposure to any of these food allergies, particularly for very serious food allergies like peanut allergy. [00:28:48] It's really really important.. We now know with schools, for example, I mean, I think schools and daycares, this general awareness now, but I think that sometimes with carers, they may not be the same awareness.

And I think some of the precautions we have to adhere to, for example, about really making sure that the foods you're preparing for a child does not have any of the Potential food allergens in them. It's really important in preparing that report. It's important when they go to a restaurant, that any dishes that potentially could have one of these food allergens is avoided. That there's no cross contamination, for [00:29:24] example, in preparing the meal, because sometimes, there can be cross contamination with cooking methods there can be shared utensils and cookware, so all of those things, we need to be mindful about.

John Salak: Certainly restaurants will respond to queries from customers?

Do you trust what restaurants are saying to you? But it seems to me, what happens behind the swinging doors of a kitchen in a big restaurant, that's got to be really difficult to maintain that sort of level of oversight.

Vincent Ho: That's exactly right. I think, you can do the sensible things, for example, that [00:30:00] before going to a particular restaurant you can certainly let them know in advance about, the food allergies and about any dishes that should be avoided in particular. But you're quite right in that there's the potential for cross contamination. That can be a real concern. I guess, you can't a hundred percent reduce that risk, but there are things that we can do sensibly to help alert us for the possibility of a reaction.

So I think that we often advise teenagers and adults when they're going out. They can cautiously test a very small amount of the food on their outer lip before putting it in their mouth. And if you get a [00:30:36] warning symptoms such as, burning or a chili like reaction and tingling, swelling, that should alert you to the possibility that a food allergen is present.

John Salak: And you would assume someone who is susceptible to a food allergy would know to do this, especially as a teenager, an adolescent, and then as an adult.

Vincent Ho: Yes, we would assume that. And I think that, young Children with allergies certainly monitored very closely by their parents.

But we know that probably around about 12 to 14 years old adolescents, they should be able to [00:31:12] not only recognize anaphylaxis symptoms. But they should also be able to carry an epinephrine auto injector. And the epinephrine auto injector basically administers epinephrine, which is life saving for anaphylaxis.

Now, what's very interesting, is that, most allergists think that, yeah, by 12 to 14, adolescents should do it. When they actually ask parents about when they expected their child to be able to manage it, most parents actually felt that kids should be more self managing at an earlier age.

In one study it [00:31:48] was felt that by six years, you know, children should be describing anaphylaxis and anywhere between six to 11 years. They should be using an epinephrine auto injector. So parents may have an assumption that their children should be able to be self efficacious when it comes to managing their own allergies at an earlier age.

John Salak: That's fascinating considering and again, we've done a podcast and written stories on not necessarily allergies, but really how parents maybe overprotect their children to such an extent that they're not prepared to launch into college by themselves, we [00:32:24] just did some some stories and and podcasts. And this is actually, we call it snow plowing in the States, but this is actually sort of the reverse is that parents say, well, you really gotta take care of yourselves at an earlier age for good reason. So, this begs the question, what about treatments? I don't know if you can use the word cure when it comes to allergies, but what do we see on the horizon and how best can people protect themselves when it comes to allergies?

Vincent Ho: Okay. So this is a really interesting and a fast moving area. There is a type of treatment called immunotherapy and it's particularly relevant when it comes [00:33:00] to peanut allergy. This is a type of treatment that focuses on building tolerance to peanut. So what happens here is the treatment is helping to desensitize the body to the allergen . And so what happens here is that you start off by exposing the child to a tiny amount of peanut protein, and then you expose it in gradually larger amounts until you hit a target dose. And what researchers have found is that by building up the peanut exposure slowly, it can help desensitize the patient to high doses of peanut [00:33:36] protein. I should stress it's a treatment, but it's not a cure for peanut algae. It's designed to help reduce that frequency and the severity of allergic reactions.

And we know that in the United States, the FDA has approved an oral immunotherapy for peanuts. There's actually a particular type of peanut powder, which is put into a capsule. And that has actually been approved by the FDA. And that's actually indicated for children with peanut allergies between the ages of four to 17.

So we know that [00:34:12] particular capsule, which contains peanut powder is available. When it comes to research there's a lot of excitement about what we call sublingual therapy So that's basically taking a tiny amount of peanut protein and taking it under the tongue where it's absorbed in the body. So, opposed to the other capture one or dimension, which you take orally, this is one where you put under the tongue and then that's absorbed into the body. And this is called sublingual immunotherapy.

And there's been some recent research that's shown that is a very safe type of treatment. And, it's still early days [00:34:48] before it can be recommended widely, but I think it's very promising. So this idea of immunotherapy is a very good one. One other point I should mention as well. And it's an important point which I do talk about in my book.

But it comes down to the recognition that children in the past, certainly over a decade ago, that were of developing peanut allergies because of family history, for example that they should avoid peanuts until they turned three years old at which stage they would have a stronger, more mature immune system.

But this strategy [00:35:24] failed to prevent peanut allergies. And so there was some research that was done about eight years ago from the United Kingdom and this is called the LEAP study. And this was a really big study which really helped change the way that we think about exposing infants to peanuts in the first 12 months of life.

So this study showed that if you ate peanuts in the first 12 months of life, that resulted in... A significantly smaller proportion of children with a peanut allergy at the age of five, compared to if you avoided peanuts. So now, the [00:36:00] recommendation is about exposing young infants to allergenic foods like peanuts.

Early on in life, in the first 12 months, they should be exposed to all these food allergens.

John Salak: This is all fascinating and there's so many segments that we could dive more deeply into the impact of food allergy on mature adults, treatments, that sort of thing. But before we wrap up, I want you to touch on maybe some of the misconceptions that people have about food allergies, either for infants.

Adolescents or adults so that they can really file this way. And this whole discussion is designed to get people thinking [00:36:36] about what they need to think more about.

Vincent Ho: So there are a number of myths about food allergies, and I think probably the most common one is that food allergies aren't serious.

I mean, we've talked before about the fact that they can be life threatening and you get anaphylaxis. And so I think they certainly can be serious. So that's probably a very common myth, which must be dispelled. Another myth is that someone who has a food allergy, even a trace of food allergen can trigger a severe reaction. So you've got to remove that allergy completely from the diet to stay, safe to live well. I think that's an important point. Another [00:37:12] myth is that each allergic reaction.

We'll get worse and worse. So there's this kind of a myth that happens. Now, the reality is that food allergy reactors are unpredictable. So the way that your body reacts to a food allergen, you just can't predict how it's going to react the next time. So in some cases, yes, it can get worse, but it may not be the case.

But I think that being said, one should always be prepared with emergency medication such as EpiPen if needed. And I think the other myth that I often see is that food allergies are viewed by some as the same as food intolerances, [00:37:48] and it's not the same thing. So, we know that food allergies are driven by, it's an immune response.

So it's driven by a reaction in the body. So what happens is that the immune system is producing a particular kind of an antibody called IgE. When it detects a food allergen. And the I. G. Then is sort of fighting against the food allergen by releasing chemicals such as histamine and that could trigger off the symptoms of an allergic reaction.

We know that food intolerances, such as, say, lactose intolerance, doesn't involve the immune system. They [00:38:24] can certainly cause some discomfort, symptoms like bloating, and gassiness, and, diarrhea, for example. But they're not life threatening. But a food allergy, on the other hand, can be fatal.

So there's a big difference between food... Intolerances and food allergies.

John Salak: Would gluten intolerance come under that as well?

Vincent Ho: Gluten intolerance would come in under that. Yes. Yes.

John Salak: Dr. Ho, this has been great. I know there's so much more we could go into. Also we will post links as to where people can get your book, but please again, tell us the title of your book.

And we will make sure that's [00:39:00] linked and promoted so that people can get that.

Vincent Ho: So my book is called the Healthy Baby Gut Guide. It's about preventing allergies, building immunity and developing good gut health. From day one.

John Salak: And who is publishing that book this book?

Vincent Ho: So it's published by Greystone books.

John Salak: We will make sure we link that so that people can get that. And we hope that we can have you on again and maybe focus down on any one of these segments as to why it's important and what people can do.

So again, I want to thank you so much for taking your time to talk to us about this and really exploring this topic with you, and hope that [00:39:36] people listening will understand some of these issues and dive in more deeply as to what they need to know so they're more educated when they deal with it themselves and when they talk to a medical professional.

So again, Dr. Ho, thank you so much for your time and today. Thank you so

Vincent Ho: much, Jonathan, for having me on.

John Salak: Before we move on to health hacks, we want to again encourage listeners to take advantage of the hundreds of exclusive discounts WellWell offers on a range of health and wellness products and services. These include everything from fitness and athletic equipment, to dietary supplements, to Personal care products, organic foods and beverages, and more.

Now signing up is easy and [00:40:12] it's free. Just visit us at wellwellusa. com. Go to Milton's discounts on the top menu bar and the signups form will appear. Signing up will take seconds, but the benefits can last for years. So how do you protect yourself from food allergies? Obviously it depends on the age of the person.

Infants and children need a lot of oversight. But beyond this, it starts with knowledge and preparation. So first off, obviously know what you're allergic to, how it affects you, and always have any related medicine on hand. Two, have a printed reaction plan on you in [00:40:48] case someone else needs to take over.

Three, read food labels thoroughly and repeatedly to make sure a substance in question isn't in the food, or perhaps under a different name. Four, wear a medical ID bracelet that covers the information about your allergy. 5. If dining out, don't just rely on the menu for food information. Let the server or manager know exactly what allergies you have so they can pass it on to the chef.

6. Let your friends and colleagues know if you are allergic to food so they can help out in an emergency. Okay, [00:41:24] that's a wrap on this edition of What the Health. I'd like to thank Dr. Vincent Ho once again for taking the time to speak with us on allergies and to cite his book once more, which is The Healthy Baby Gut Book Guide.

So, again, thanks for listening in, and we hope you'll join us again on What the Health.

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